Anal cancer is typically found in one of the following ways:
As an incidental finding on a biopsy for another reason
During surveillance for anal intraepithelial neoplasia (precancerous lesion)
Imaging for all patients with anal cancer should include chest/abdominal/ pelvic CT to evaluate for enlarged lymph nodes and metastatic spread. Female patients should be evaluated with a thorough gynecologic examination, including screening for cervical cancer. PET/CT can be considered in certain clinical scenarios.
In patients with anal squamous cell carcinoma, colonoscopy is also recommended because colorectal neoplasm is discovered at the time of diagnosis in 15% of cases, although no link between colon and rectal cancer and anal cancer has been established.
Currently, no major regulatory or professional body recommends anal cancer screening for the general population, and controversy surrounds the questions of which patients are candidates for screening and what techniques should be used. In general, screening is recommended in patients at high risk for anal cancer, such as the following:
Some immunocompromised patients (eg, kidney or liver transplant recipients)
Patients with anogenital warts
HIV-positive men who have sex with men
For more on the workup of anal cancer, read here.
Medscape © 2017 WebMD, LLC
Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: Elwyn C. Cabebe. Fast Five Quiz: How Much Do You Know About Anal Cancer? - Medscape - Oct 30, 2017.